Psychiatrists with Whitehorse’s Summit Heath Associates clinic have withdrawn their services from Whitehorse General Hospital after one of them was “brutally assaulted” by a patient in the secure medical unit last week.
The assault, according to a letter obtained by the News, occurred the day after psychiatrists sent emails “pleading” with officials to put additional security measures in place because they’d anticipated violence from that patient, but were told funding wasn’t available.
“After more than one year of providing full-time 365 day coverage at the hospital, we are saddened to confirm that we have withdrawn our services from (Whitehorse General Hospital),” the Summit Health psychiatry team said in an emailed statement to the News Nov. 3.
The team was part of the staff treating patients in the hospital’s secure medical unit, a dedicated mental health ward on the second floor with five beds and two seclusion rooms officials have previously acknowledged is in need of an overhaul.
The assault occurred on Oct. 28, according to Summit Health’s statement, and happened despite the team “pleading for improved standards at the hospital since we started working in the Yukon by raising concerns about the safety of our patients, staff, and physicians.”
“We have worked tirelessly to reform Yukon mental health services in the last year, and are heartbroken to withdraw care,” the statement says.
“However, our work means little without a safely designed unit, properly trained security and staff, and therapeutic programming for our patients. Status quo is no longer satisfactory and Yukoners deserve better.”
It adds that Summit Health will “not stop advocating to our hospital and government for safe mental health care that Yukoners desperately need, and hope to be able to reconsider our withdrawal.”
Separately, the News obtained a letter a Summit Health psychiatrist sent to other doctors on Oct. 30 informing them of the withdrawal from Whitehorse General Hospital until a safer, adequately-resourced working environment could be provided.
According to the letter, the psychiatrists had “accepted the risks” of working on the secure medical unit on the “good faith” that a safer unit was being built, but learned that the risks were “critical” and had endured “numerous ‘near misses’” prior to the assault.
“For many patients… the inadequate environment itself forces us to keep patients in seclusion for unethical periods of time as the only ‘safe option’, which at best is a human rights violation, and at worse incites aggression and violence as observed in this incident,” the letter reads in part.
“It is without exaggeration that I say practising ‘inpatient psychiatry’ here has been akin to being forced to do surgery in a broom closet and without anesthesia… We have considered withdrawing out services multiple times in the last year, and it took this assault to commit to that decision.”
The letter outlines three “immediate changes” needed to ensure the safety of patients and staff, including the ability to immediately medevac patients who would likely need “psychiatric ICU placement,” having a minimum of four security guards on shift and “code white” training for all staff, which the letter says should be done annually but hasn’t occurred for the last 14 years.
“Code white” is a term used by hospitals to refer to patients acting violently or out-of-control.
Yukon Hospital Corporation spokesperson Chris Huestis confirmed in an email Nov. 2 that “an unfortunate and regrettable violent incident has resulted in psychiatrists withdrawing consult services” to the hospital.
He described the situation as having arisen after “a patient’s needs exceeded the capacity of our hospital,” explaining that the secure medical unit “is not designed to support mental health patients who need a higher level of care.”
“The unit provides stabilization and observation until transfer to a more appropriate mental health care facility,” Huestis wrote. “In this case, a space in a more appropriate space in mental health care facility has not yet been available, and we have been unable to transfer the patient. Additional security coverage was put in place as well as other risk management protocols.”
He added that other physicians are continuing to offer services to patients on the unit, while psychiatric consults are being provided by a British Columbia-based service as needed.
Questions about the safety and adequacy of Whitehorse General’s secure medical unit have been raised since at least 2011, when a patient walked out and then was lost in the woods for two days.
Yukon health officials themselves have also previously acknowledged the unit’s shortcomings; health and social services minister Pauline Frost, while giving a ministerial statement in the legislative assembly in April 2019, said that the Yukon Hospital Corporation was planning for the development of an improved secure medical unit as the current one “does not meet current client and patient safety standards.”
The territory’s 2019-2020 budget set aside $1 million for the “planning and design” of the new unit; Frost told reporters Nov. 3 that there was $1 million in 2020-2021 for a “planning budget” and “program design,” while a “significant amount of money in the capital budget” for 2022-2023 will be earmarked for the actual design and build of the new unit.
In the legislative assembly, Yukon Party leader Stacey Hassard noted that the Whitehorse General Hospital’s new emergency department, opened in 2018, had been constructed with space set aside upstairs for a new, “badly-needed” secure medical unit.
Frost responded that the unit was being planned, “but it also is in the stages of being finalized to move forward to development.”
Contact Jackie Hong at firstname.lastname@example.org